MilaMooski
05-17-2018, 01:38 AM
We have the most amazing boxers Mila and Joey. Mila turns 12 next month and Joey will be 10 this July. Both were rescued as puppies.
Aside from some allergy issues as pups (that was treated with sulphur and apis through a holistic vet) we've been blessed with two of the happiest, healthiest, trouble-free boxer babies since day one.
Last December, Mila started tripping when getting out of our RV (we travel full time). Aside from taking quite the tumble down the steps, we didn't think much of it at the time. (She gets up and shakes it off.) From January through March, her joints began to get extremely rigid and she began having more issues walking. We were still going on short walks and hikes but they have decreased more and more each week.
As luck would have it, Joey recently had a few days of vomiting after eating. Something that is very rare for him. So after a couple of days we decided to take him to the vet just to get him checked out. (He did check out a-ok and hasn't had a problem keeping his food down since that day.)
We started talking about Mila's stiffening joints and the vet suggested that it didn't sound like "old age" and that he would be happy to take a look at her. We bring Mila in and after a few minutes he tells me this doesn't look normal. Suggests a blood test to see if anything shows up.
I am grateful that something came up with Joey that got us to the vet talking about Mila.
First blood test only reveals slightly low Thyriod levels.
We did a round of x-rays - she looks perfect.
He recommends a Neuroligst in a nearby town.
Neurologist is stumped by her stiffness. Suggests the local vet run a cushings test.
Consult Notes from Neurologist:
Patient: Mila, 11 yr FS Boxer
History: Signs began Fall 2017. Dragging paws front and rear. Problem is progressive. Tendency to have extensor rigidity of limbs; fore in particular. Owner perceives some pain associated with these signs although cant really localize source. She has been knuckling pelvic paws. No other signs of systemic illness. No known chronic illness. Travel in the last 3 years has included most of the West (including Phoenix) but all over country.
Current Medications: Thyroid supplement
Lab results: Radiographs spine, thorax, abdomen, pelvis unremarkable. Blood tests done recently and only abnormal was slight low T4 per owner (not available for my review).
Physical Exam findings: BW= 24 kg T=101.3 mm, eent, pln, h&l, abd, m/s, integ (haircoat in general is thin and she is losing hair, two raised alopecic erythematous plaques central thorax) all WNL unless otherwise listed in parentheses.
Neuro exam findings:
1) Mentation-QAR, appropriate
Posture and gait- ambulatory with difficulty. All 4 limbs are extensor rigid and stiff impeding normal gait. She walks without obvious proprioceptive ataxia and does not have abnormal nail wear pelvic limbs
Postural Reactions- difficult to assess because of stiff limbs, but static CP and hopping appear within normal limits
Cranial nerves- normal
LMN/segmental reflexes- Excessive extensor tone all limbs. Difficult to bend limbs even with force .
Neuroanatomic localization: Suspect peripheral myopathy
Differential diagnoses: Cushings myopathy, polymyositis, atypical tetanus, other
Recommendations:
Attempt to definitively exclude Hyperadrenocorticism (low dose Dex suppression, ultrasound of adrenal glands, etc). If this is diagnosed, secondary myopathy could be presumed
If CK was not measured on the routine labwork, I also recommend submitting serum for CK levels. This could be done at time of Cushings testing
Alternatively, we could do muscle biopsy here locally which would tell us both about Cushings and other possible myopathies
Non invasive but diagnostic testing for Cushings myopathy can be achieved with electromyography with a neurologist on the front range who has this equipment.
If this is Cushings myopathy, there is no known proven effective therapy. Effectively managing the cushings may help, but significant improvements are not likely.
We did the Cushings test. It came back positive. I don't have the results for that one.
Last Thursday we did the High Dose Dexametasone Supression Test
Here are the results.
Pre-Dex: 3.6
Post 4 HR: 3.5
Post 8 HR: 2.8
Apparently these results don't tell us whether it is a pitutary or an adrenal cushings. So our next step is to go for an ultrasound.
We have reached out to our holistic vet and she can do a phone consult (we're hundreds of miles away)
We have also scheduled an appointment with a certified accupuncture / chinese medicine vet next week.
She pants a lot, drinks a lot, is hungry all of the time, but no weight gain.
And her hair has definitely started thinning and skin is becoming scaly with a few small scabs.
She was running like a pup less than 6 months ago and we will do whatever we can to make her remaining time with us as enjoyable as possible.
So I guess I'm wondering if anyone has had any experience with the stiffness and if anyone has had luck with eastern medicine vs western medicine. We're open to trying anything to help her feel better.
Are there any specialists anyone would recommend in Utah or Colorado?
Sorry for the long post and thank you in advance for reading this...
Michelle
Aside from some allergy issues as pups (that was treated with sulphur and apis through a holistic vet) we've been blessed with two of the happiest, healthiest, trouble-free boxer babies since day one.
Last December, Mila started tripping when getting out of our RV (we travel full time). Aside from taking quite the tumble down the steps, we didn't think much of it at the time. (She gets up and shakes it off.) From January through March, her joints began to get extremely rigid and she began having more issues walking. We were still going on short walks and hikes but they have decreased more and more each week.
As luck would have it, Joey recently had a few days of vomiting after eating. Something that is very rare for him. So after a couple of days we decided to take him to the vet just to get him checked out. (He did check out a-ok and hasn't had a problem keeping his food down since that day.)
We started talking about Mila's stiffening joints and the vet suggested that it didn't sound like "old age" and that he would be happy to take a look at her. We bring Mila in and after a few minutes he tells me this doesn't look normal. Suggests a blood test to see if anything shows up.
I am grateful that something came up with Joey that got us to the vet talking about Mila.
First blood test only reveals slightly low Thyriod levels.
We did a round of x-rays - she looks perfect.
He recommends a Neuroligst in a nearby town.
Neurologist is stumped by her stiffness. Suggests the local vet run a cushings test.
Consult Notes from Neurologist:
Patient: Mila, 11 yr FS Boxer
History: Signs began Fall 2017. Dragging paws front and rear. Problem is progressive. Tendency to have extensor rigidity of limbs; fore in particular. Owner perceives some pain associated with these signs although cant really localize source. She has been knuckling pelvic paws. No other signs of systemic illness. No known chronic illness. Travel in the last 3 years has included most of the West (including Phoenix) but all over country.
Current Medications: Thyroid supplement
Lab results: Radiographs spine, thorax, abdomen, pelvis unremarkable. Blood tests done recently and only abnormal was slight low T4 per owner (not available for my review).
Physical Exam findings: BW= 24 kg T=101.3 mm, eent, pln, h&l, abd, m/s, integ (haircoat in general is thin and she is losing hair, two raised alopecic erythematous plaques central thorax) all WNL unless otherwise listed in parentheses.
Neuro exam findings:
1) Mentation-QAR, appropriate
Posture and gait- ambulatory with difficulty. All 4 limbs are extensor rigid and stiff impeding normal gait. She walks without obvious proprioceptive ataxia and does not have abnormal nail wear pelvic limbs
Postural Reactions- difficult to assess because of stiff limbs, but static CP and hopping appear within normal limits
Cranial nerves- normal
LMN/segmental reflexes- Excessive extensor tone all limbs. Difficult to bend limbs even with force .
Neuroanatomic localization: Suspect peripheral myopathy
Differential diagnoses: Cushings myopathy, polymyositis, atypical tetanus, other
Recommendations:
Attempt to definitively exclude Hyperadrenocorticism (low dose Dex suppression, ultrasound of adrenal glands, etc). If this is diagnosed, secondary myopathy could be presumed
If CK was not measured on the routine labwork, I also recommend submitting serum for CK levels. This could be done at time of Cushings testing
Alternatively, we could do muscle biopsy here locally which would tell us both about Cushings and other possible myopathies
Non invasive but diagnostic testing for Cushings myopathy can be achieved with electromyography with a neurologist on the front range who has this equipment.
If this is Cushings myopathy, there is no known proven effective therapy. Effectively managing the cushings may help, but significant improvements are not likely.
We did the Cushings test. It came back positive. I don't have the results for that one.
Last Thursday we did the High Dose Dexametasone Supression Test
Here are the results.
Pre-Dex: 3.6
Post 4 HR: 3.5
Post 8 HR: 2.8
Apparently these results don't tell us whether it is a pitutary or an adrenal cushings. So our next step is to go for an ultrasound.
We have reached out to our holistic vet and she can do a phone consult (we're hundreds of miles away)
We have also scheduled an appointment with a certified accupuncture / chinese medicine vet next week.
She pants a lot, drinks a lot, is hungry all of the time, but no weight gain.
And her hair has definitely started thinning and skin is becoming scaly with a few small scabs.
She was running like a pup less than 6 months ago and we will do whatever we can to make her remaining time with us as enjoyable as possible.
So I guess I'm wondering if anyone has had any experience with the stiffness and if anyone has had luck with eastern medicine vs western medicine. We're open to trying anything to help her feel better.
Are there any specialists anyone would recommend in Utah or Colorado?
Sorry for the long post and thank you in advance for reading this...
Michelle